The candidate for this NIH K24 award is a gastroenterologist and Associate Professor of Medicine at Baylor College of Medicine (BCM), where she holds joint appointments in the Gastroenterology (GI) and Health Services Research Sections. Dr. Rabeneck began her full-time academic career in 1990, upon obtaining her MPH degree at Yale University, where she trained as a Robert Wood Johnson Clinical Scholar. She has been successful in obtaining VA and NIH support for her work, and has achieved national recognition for outcomes research in digestive diseases. Dr. Rabeneck recently held a 3-year VA. HSR&D Advanced Research Career Development Award, which facilitated her career development by providing relief from heavy clinical responsibilities. With this NIH K24 award, Dr. Rabeneck seeks to expand her mentoring activities and enhance her research skills. Dr. Rabeneck has a strong record of mentoring junior individuals and is committed to training the next generation of clinical investigators focusing on patient-oriented research. Dr. Rabeneck's plans over the 5 years of this award are to: 1) continue and expand her current mentoring of trainees and junior faculty; 2) establish a GI/MPH Track within the BCM GI Fellowship Program; and 3) establish a GI Epidemiology/Outcomes Research Group at BCM. This proposal makes use of the following outstanding resources: 1) Houston VA HSR&D Center of Excellence, one of 11 such programs in the U.S., a consortium of over 22 MD and PhD investigators; 2) a new NIH P30 award for BCM's Center for Gastrointestinal Development, Infection, and Injury, on which Dr. Rabeneck serves as Director, Clinical Core; 3) BCM's NIH K30 funded Clinical Scientist Training Program; 4) the University of Texas-Houston School of Public Health; 5) Research Endoscopy Unit; and 6) GI Mucosa Pathology Laboratory. Dr. Rabeneck's research focuses on the measurement and therapy of uninvestigated dyspepsia. Project #1, which makes use of previously collected data, will evaluate the relationships between three dimensions of dyspepsia (pain intensity; non-pain symptoms; satisfaction), and explore new methods for the analysis of outcome data. Project #2 is a multicenter randomized controlled trial of 330 H. pylori-infected patients presenting with dyspepsia without alarm features at 5 primary care sites in Houston. Patients will be randomized to combined antimicrobial-antisecretory therapy versus antisecretory therapy alone versus prompt endoscopy. The patients will be followed over 1 year. The trial will examine the hypothesis that combined antimicrobial-antisecretory therapy is more efficacious than either prompt endoscopy or antisecretory therapy alone.